Inguinal Hernia Overview & Treatment

Inguinal hernias are those that occur in the groin area. Much like other types of hernias, they occur when a portion of the small intestine pushes through the lower abdominal wall, also known as the fascia. Inguinal hernias occur most often in male patients – up to 90% or more of cases. However female patients can also develop this type of hernia.  Inguinal hernias represent the vast majority of hernia surgeries in the United States and around world. As with any other hernia, the size of the inguinal hernia does not necessarily correlate with its symptoms. Further, an inguinal hernia can be repaired in an open or minimally invasive / laparoscopic manner depending on the patient’s particular circumstance.

Causes of Inguinal Hernias

The root cause of an inguinal hernia can vary dramatically between patients. We do know that there is a correlation between genetics and the development of hernias. In some cases, improper closure of the testicular canal at birth may allow part of the intestine to push through, causing a hernia. However, we also know that significant strain in the abdominal area can cause an inguinal hernia. Lifting heavy objects and even strong sneezes or coughs can cause a hernia or make an existing or asymptomatic hernia worse.

Symptoms of Inguinal Hernias

Many patients go through a part or even their entire life without knowing that they have a hernia. Commonly, hernias are only detected during a routine physical. Indeed, asymptomatic hernias are often left alone and the only treatment is watchful waiting – waiting to see if the hernia becomes symptomatic. If it does, there are two common symptoms of an inguinal hernia – pain and subcutaneous bulging. Many patients will feel some degree of discomfort or pain when lifting heavy objects, exercising or straining the abdomen. This discomfort may come in the form of burning, a dull ache or sharp pain. Further, this pain may travel – called referred pain – to other parts of the abdomen.

However, not all hernias cause pain, but patients may feel a lump in their groin. Typically, the protrusion can be pushed back into the abdomen using light pressure. This is a clear indication of a hernia. For those cases that remain protruding, there is a greater risk of strangulation which is an emergency procedure.  Strangulation or incarceration of an inguinal hernia can cause significant pain and requires an immediate trip to the emergency room. When it is strangulated, blood flow is cut off to the organ, which in turn, can destroy intestinal tissue. As a result, in rare cases, part of the intestine may also have to be resected or removed.

Treatment for Inguinal Hernias

An inguinal hernia must be treated surgically. Surgical hernia repair options include open (a single, large incision) or laparoscopic (using small, specially made surgical tools to access the abdomen in a minimally invasive manner).

A hernia can also be repaired with or without mesh, usually made of a synthetic material like polypropylene or polyester. This mesh tends to reduce the recurrence rate of the hernia. However, there is some debate as to whether it may cause biocompatibility related complications. Indeed, there are animal-tissue hernia meshes available on the market today.

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